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PRESIDENT Obama and con gressional Democrats are now fixing their gun sights on health insurers, but their broader, underlying goals remain unchanged: socializing costs and extending Washington’s control of the health-care sector.

This takes what Obama told Joe the Plumber about “spreading the wealth” a step further. Because not only do the reforms redistribute wealth by shifting costs; they also put government in charge of spending even more of the nation’s money.

And they can do it via a “public option” or heavy insurance regulation and mandates.

Follow along: Obama is now blasting insurers, claiming they “do nothing to improve care and everything to improve their profits.” Imagine: companies looking to make a buck!

Actually, according to this year’s Fortune 500 rankings, health care’s evil “insurance and managed care” sector placed far from the top in profitability among the nation’s top industries — wringing margins from poor, “victimized” Americans to the tune of just 2.2 percent of revenues. Quelle horreur!

What he means is that if someone never pays a dime for insurance (and never has an employer buy it for him, either) but suddenly falls ill, insurers should nonetheless give him insurance, and at the same rate they charge everyone else — and cover his medical bills.

But those medical bills may well exceed the revenue they collect from his premiums. Which means everyone’s premiums will have to go up, to pay for these “free riders.”

Obama has also lashed out against the firms for imposing deductibles and limiting benefits. But insurers do that to cap their potential payouts — so changing these practices along the lines Obama wants will also cost them more.

Think about it: If companies have to provide unlimited reimbursements to cover unlimited treatments, and with little or no out-of-pocket expenses from patients, they’ll either have to eat the higher costs themselves or raise rates to pay for it.

And, again, with profits of just 2.2 percent of revenues, they can’t eat many costs. So rates will go through the roof.

Where would the money come from for higher premiums? Under ObamaCare, they’d come from taxpayer subsidies and, perhaps, universal mandates.

If everyone must get insurance, there’ll be plenty of cash coming in. And for those who can’t afford to buy their policy, the government (i.e., taxpayers) will pick up the tab.

Meanwhile, a “one rate fits all” plan will shift costs — from old to young, sick to healthy, reckless to prudent.

Gone would be any last shred of personal responsibility for one’s health — or for the financial obligations of health care.

And because people would get medical services no matter what, and thus have no need to weigh their costs and benefits, government rules would wind up doing it for them, through rationing.

Again, Obama doesn’t need a “public option” to do this — regulating insurers can reach the same goal. Either way, government would end up effectively:

* Mandating how much money is to be spent on health care.

* Socializing costs.

* Deciding what kind of care Americans must buy.

And, again, you don’t need a “public option” to accomplish this. On a New York Times blog Monday, Princeton University economist Uwe Reinhardt pointed to Holland, Germany and Switzerland, where private insurers “are goaded by tight regulation to work toward socially desired ends.”

Yet there are plenty of ways to unleash capitalist forces to drive costs down and fix current woes, like the risk of losing your insurance when you switch jobs.

For starters, there’s no reason to ban folks from buying policies out of state, as is the case now. Nor to give tax breaks only for employer-provided insurance.

Dropping state mandates for unnecessary benefits can also cut costs and broaden “choice.” And, of course, the unmentioned elephant in the room: medical-malpractice tort relief.

But again, fixing such problems isn’t ObamaCare’s chief goal. It’s using the powers of government to redistribute costs and dictate spending. Whether through a public plan or intensive regulation.